Old Drugs: New Uses

An Oxford University Randomised Evaluation of COVID-19 Therapy (RECOVERY) trial seems to be firming up (https://www.cidrap.umn.edu/news-perspective/2021/02/tocilizumab-cuts-death-rate-severe-covid-19-study-finds). This RECOVERY trial involved more than 4000 severely-ill and hospitalised coronavirus patients. Half the subjects were given Tocilizumab (an anti-inflammatory, monoclonal antibody traditionally used to treat arthritis of the joints). The remainder (controls) received standard hospital care. Most subjects (82%) in both groups were also injected with the anti-inflammatory (and cheap) steroid, Dexamethasone (already shown to be helpful in treating patients with a severe Covid-19 infection). The trial's most striking findings were that the Tocilizumab/Dexamethasone combination reduced mortality by a) about a third, in patients getting simple oxygen supplimentation and b) nearly half, in counterparts subjected to invasive mechanical ventilation. Tocilizumab treatment had some side-effects but all appeared manageable. People worry about the ethical problems associated with these randomised trials (what are the control group getting out of it?) but there really is no other way to establish, which treatments work and which do not. Getting properly 'informed consent' from frightened people and their families is, however, an issue. Otherwise, medical advances would be based entirely on guesswork. It looks as if we have a useful addition to our armamentarium for treating life-threatening Covid-19 infections?